Induced abortion: incidence and trends worldwide from 1995 to 2008.

Contents

Abstract

Background
Data of abortion incidence and trends are needed to monitor progress
toward improvement of maternal health and access to family planning. To
date, estimates of safe and unsafe abortion worldwide have only been
made for 1995 and 2003.

Methods
We used the standard WHO definition of unsafe abortions. Safe abortion
estimates were based largely on official statistics and nationally
representative surveys. Unsafe abortion estimates were based primarily
on information from published studies, hospital records, and surveys of
women. We used additional sources and systematic approaches to make
corrections and projections as needed where data were misreported,
incomplete, or from earlier years. We assessed trends in abortion
incidence using rates developed for 1995, 2003, and 2008 with the same
methodology. We used linear regression models to explore the association
of the legal status of abortion with the abortion rate across subregions
of the world in 2008.

Findings
The global abortion rate was stable between 2003 and 2008, with rates
of 29 and 28 abortions per 1000 women aged 15-44 years, respectively,
following a period of decline from 35 abortions per 1000 women in 1995.
The average annual percent change in the rate was nearly 2.4% between
1995 and 2003 and 0.3% between 2003 and 2008. Worldwide, 49% of
abortions were unsafe in 2008, compared to 44% in 1995. About one in
five pregnancies ended in abortion in 2008. The abortion rate was lower
in subregions where more women live under liberal abortion laws (p

Interpretation
The substantial decline in the abortion rate observed earlier has
stalled, and the proportion of all abortions that are unsafe has
increased. Restrictive abortion laws are not associated with lower
abortion rates. Measures to reduce the incidence of unintended pregnancy
and unsafe abortion, including investments in family planning services
and safe abortion care, are crucial steps toward achieving the
Millennium Development Goals.